Mobiele menu

SiMiLAR study: Design of a Sustainable workflow to Monitor and control health care related transmission of LA-MRSA

Projectomschrijving

Vee gerelateerde (LA-)MRSA lijkt minder makkelijk van mens op mens overdraagbaar dan andere typen MRSA. Daarom hebben enkele ziekenhuizen in gebieden met veel vee het beleid voor patiënten die (mogelijk) drager zijn van LA-MRSA versoepeld. Dit is fijner voor patiënten. Omdat bacteriën zich goed kunnen aanpassen is het belangrijk de veiligheid van dit beleid te bewaken.

De deelnemende ziekenhuizen ontwikkelen samen met het RIVM een werkwijze om snel clusters van LA-MRSA te signaleren. We gebruiken de bestaande gegevens van LA-MRSA stammen van de ziekenhuizen uit de landelijke database TypeNed. Door de genetische informatie, het moment en de plaats waar deze bacteriën zijn aangetroffen te combineren zoeken we clusters van LA-MRSA. De ontwikkelde criteria testen we op de bestaande collectie van LA-MRSA. Vervolgens ontwikkelen we een werkwijze om met deze criteria ook snel clusters in nieuwe LA-MRSA te signaleren. Zo houden we de zorg in veedichte gebieden veilig en comfortabel.

Verslagen


Samenvatting van de aanvraag

Methicillin-resistant Staphylococcus aureus, or MRSA, is a type of staph bacteria that has become resistant to many antibiotics. It is associated with significant morbidity and mortality. To protect patients from MRSA-infections, hospitals invest considerable efforts in prevention of transmission of MRSA. Several types of MRSA can be distinguished. Hospital acquired MRSA (HA-MRSA), associated with treatment and care in nosocomial settings, community acquired MRSA (CA-MRSA), which emerged in the community, and livestock associated MRSA (LA-MRSA) of which the main source is farm and domestic animals. Hospitals in livestock dense areas are faced with high numbers of patients and health care workers with (risk factors for) LA-MRSA. Although compared to HA-MRSA, LA-MRSA is less transmissible from human to human in a hospital setting, the latest Dutch infection control guideline prescribes equally strict isolation procedures for both LA- and HA-MRSA. Still, some of the hospitals in livestock dense areas, have implemented a less comprehensive isolation policy for patients with (risk factors for) LA-MRSA. This policy includes admitting these patients in contact isolation instead of strict isolation, and allowing health care workers who carry LA-MRSA to work in the hospital under controlled conditions. Those hospitals are no longer compliant to the national guideline for MRSA. In order to be able to assess whether this downscaling of isolation precautions is safe, epidemiological measurements over a longer period of time are necessary to detect low-grade spread of certain strains. In this study typing data are combined with epidemiological data to asses if real time WGS can be a valuable tool in the future to detect health care associated spread of LA-MRSA. In this project we develop and implement a workflow to sustainably assess transmission of LA-MRSA in health care settings. Existing data from the national MRSA surveillance in TypeNed and epidemiological data from the infection control departments from hospitals are analysed to identify transmission events. First, possible clusters of LA-MRSA strains will be identified by extracting LA-MRSA of unknown origin (LA-MUO) from TypeNed, linking them to similar type LA-MRSA of patients that have been in the same hospital in the same timeframe. Then the genetic similarity within the potential clusters is further investigated by additional whole genome sequencing (WGS) of the LA-MRSA strains deposited in TypeNed, and clusters are defined. These will be linked to detailed infection control data from the hospitals to rate the risk of health care related transmission within each cluster. Based on the findings a model to identify possible clusters of healthcare related transmission of LA-MRSA is developed. Based on this analysis a workflow for sustainable near real time monitoring of health care related (HCR) transmission of LA-MRSA is developed. Implementation of this workflow will enhance the quality of patient care and patient safety.

Onderwerpen

Kenmerken

Projectnummer:
541003008
Looptijd: 100%
Looptijd: 100 %
2020
2023
Onderdeel van programma:
Gerelateerde subsidieronde:
Projectleider en penvoerder:
drs. C.M. Habben Jansen
Verantwoordelijke organisatie:
Jeroen Bosch Ziekenhuis